Provider Demographics
NPI:1467092064
Name:MATTHEW T. TOMODA DDS PC
Entity Type:Organization
Organization Name:MATTHEW T. TOMODA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-292-7662
Mailing Address - Street 1:12057 HANOVER COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:VA
Mailing Address - Zip Code:23069-1600
Mailing Address - Country:US
Mailing Address - Phone:540-292-7662
Mailing Address - Fax:
Practice Address - Street 1:9150 DICKEY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2502
Practice Address - Country:US
Practice Address - Phone:540-292-7662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental